Bone plate having combination locking and compression screw holes

ABSTRACT

A bone plate including a first side and a second side and configured to locate a locking screw and a compression screw. The bone plate includes a top surface and a bottom surface each extending between the first side and the second side. A plurality of holes extend from the top surface to the bottom surface include a hybrid screw hole configured to accept both a locking screw and a compression screw, a first form hole configured to accept a locking screw, and a second form hole having an elongated shape with a non-circular cross-section configured to accept a compression screw. An interior wall of the bone plate extends between a top opening and a bottom opening of the hybrid screw hole wherein the interior wall includes a threaded first portion proximate the top opening and an unthreaded second portion extending from the bottom opening.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.14/021,215 filed Sep. 9, 2013, and entitled “Bone Plate HavingCombination Locking and Compression Screw Holes,” which is a divisionalof U.S. patent application Ser. No. 13/019,639, filed Feb. 2, 2011, nowissued as U.S. Pat. No. 8,551,095, entitled “Bone Plate HavingCombination Locking and Compression Screw Holes,” the disclosures ofwhich are expressly incorporated in their entirety herein by thisreference.

FIELD OF THE INVENTION

The present disclosure is directed to bone plates and, morespecifically, to bone plates having fastener holes that may be utilizedas locking holes or as compression holes, depending upon the initialplacement of the fastener with respect to the fastener hole.

BRIEF DISCUSSION OF RELATED ART

Bone plates used in conjunction with screws to fix bone fractures oftencontain locking screw holes and compression slots. Locking screw holesprovide additional plate-to-screw fixation to lock bone fragments inplace and aid in healing of bone fractures. Compression slots, on theother hand, are used to compress the ends of bone fragments together toaid in primary healing.

Typically, a bone plate includes at least one locking screw hole and atleast one compression slot. The location of the holes and slots dictatethe locations on the bone plate where the surgeon can apply locking orcompression forces.

INTRODUCTION TO THE INVENTION

The present invention is directed to bone plates having fastener holesthat may be utilized as locking holes or as compression holes, dependingupon the initial placement of the fastener with respect to the fastenerhole. By providing a single hole that can act as a compression hole or alocking hole, the bone plate provides a surgeon with greater flexibilityas to the placement of locking fasteners and compression fasteners in asmaller footprint than in a traditional plate having dedicated space foreach type of hole.

It is a first aspect of the present invention to provide a bone plateincluding a hybrid through screw hole, where the hybrid through screwhole includes a top opening and a bottom opening, the top opening beinggenerally circular and including a widthwise dimension and a lengthwisedimension normal to the widthwise dimension, where an interior wall ofthe bone plate extends between the top opening and the bottom opening,where at least a portion of the interior wall proximate the top openingis threaded, and where at least one of the widthwise dimension and thelengthwise dimension is decreased between the top opening to the bottomopening, while the other of the widthwise dimension and the lengthwisedimension does not substantially decrease between the top opening andthe bottom opening.

In a more detailed embodiment of the first aspect, the interior wallincludes a first portion having a first circumferential curvature and asecond portion having a second circumferential curvature, wherein thefirst circumferential curvature is larger than the secondcircumferential curvature. In yet another more detailed embodiment, thesecond portion does not include threads. In a further detailedembodiment, the first portion is at least one of arcuate and tapered inthe vertical direction and, the second portion includes a vertical wall.In still a further detailed embodiment, the interior wall includes afirst portion having a first circumferential curvature, a second portionhaving a second circumferential curvature, and a third portion having athird circumferential curvature, wherein the first circumferentialcurvature is larger than the second circumferential curvature and thethird circumferential curvature. In a more detailed embodiment, thesecond portion is opposite the third portion. In a more detailedembodiment, the second circumferential curvature is generally the sameas the third circumferential curvature. In another more detailedembodiment, the first portion includes threads, the second portion doesnot include threads and, the third portion does not include threads. Inyet another more detailed embodiment, the first portion is at least oneof arcuate and tapered in the vertical direction, the second portionincludes a vertical wall and, the third portion includes a verticalwall.

It is a second aspect of the present invention to provide a bone platecomprising a combination compression and locking through hole, where thecombination hole includes a first portion having a circular, horizontalcross-section and a second portion having an oblong, horizontalcross-section, where the circular, horizontal cross-section and theoblong, horizontal cross-section lie along differing planesperpendicular to a central axis extending through the combinationcompression and locking through hole.

In a more detailed embodiment of the second aspect, the bone platefurther includes a plurality of combination compression and lockingthrough holes, where each of the plurality of combination compressionand locking through holes includes a first portion including a circular,horizontal cross-section and a second portion including an oblong,horizontal cross-section. In yet another more detailed embodiment, thecombination compression and locking through hole is at least partiallythreaded. In a further detailed embodiment, the first portion isthreaded and the second portion is unthreaded. In still a furtherdetailed embodiment, the first portion includes a diameter D, the secondportion includes a maximum length L and, the diameter D is approximatelyequal to the length L.

It is a third aspect of the present invention to provide a bone platecomprising a through screw hole demarcated by an interior surface of thebone plate that extends between a top opening and a bottom opening, thetop opening having a continuous arcuate shape and allowing throughput ofa first imaginary cylinder having a circular cross-section with adiameter D1, the interior surface having a first segment that is atleast partially threaded and tapers to a stopping distance SD to inhibitthroughput of the first imaginary cylinder at a location between the topopening and the bottom opening, the interior surface having a secondsegment adjacent to the first segment, the first segment and the secondsegment allowing throughput of a second imaginary cylinder having acircular cross-section with a diameter D2, where the diameter D1 isgreater than the diameter D2, where the stopping distance SD is greaterthan D2, and wherein a maximum horizontal distance across the secondsegment is greater than 1.3 times D2.

In a more detailed embodiment of the third aspect, the interior surfaceof the first segment includes a first circumferential curvature and thesecond segment includes a second circumferential curvature, wherein thefirst circumferential curvature is larger than the secondcircumferential curvature. In yet another more detailed embodiment, thesecond segment does not include threads. In a further detailedembodiment, the first segment is at least one of arcuate and tapered inthe vertical direction and, the second segment includes a vertical wall.In still a further detailed embodiment, the interior surface includes afirst segment having a first circumferential curvature, the secondsegment includes a second portion having a second circumferentialcurvature and a third portion having a third circumferential curvature,wherein the first circumferential curvature is larger than the secondcircumferential curvature and the third circumferential curvature. In amore detailed embodiment, the second portion lies generally opposite thethird portion. In a more detailed embodiment, the second circumferentialcurvature is generally the same as the third circumferential curvature.In another more detailed embodiment, the first portion includes threads,the second portion does not include threads and, the third portion doesnot include threads. In yet another more detailed embodiment, the firstportion is at least one of arcuate and tapered in the verticaldirection, the second portion includes a vertical wall and, the thirdportion includes a vertical wall.

It is a fourth aspect of the present invention to provide a method offorming a bone plate comprising: (a) fabricating a bone plate to includea first through hole, where at least one of a width and a length of thehole changes along a depth of the hole; (b) plunge milling an interiorsurface of the bone plate demarcating the first through hole to removeat least a portion of the bone plate to increase at least one of thewidth and the length of the through hole; and (c) threading at least aportion of the first through hole.

In a more detailed embodiment of the fourth aspect, threading at least aportion of the first through hole occurs before the plunge milling act.In yet another more detailed embodiment, threading at least a portion ofthe first through hole occurs after the plunge milling act. In a furtherdetailed embodiment, the length and width of the through hole at a topsurface of the bone plate are identical. In still a further detailedembodiment, the length and width of the through hole at a bottom surfaceof the bone plate are identical after the fabricating act and, thelength and width of the through hole at the bottom surface of the boneplate are not identical after the plunge milling act. In a more detailedembodiment, the plunge milling act includes using an end mill to removematerial in a cylindrical swath, a first axis extends through a centerof the through hole, a second axis extends through a circular center ofthe cylindrical swath and, the first axis is parallel with the secondaxis. In a more detailed embodiment, the plunge milling act includesusing an end mill to remove material in a cylindrical swath, the plungemilling act includes applying the cylindrical swath to opposing ends ofthe through hole to create a first cylindrical swath and a secondcylindrical swath, the first cylindrical swath includes a first axisextending through a circular center thereof, the second cylindricalswath includes a second axis extending through a circular centerthereof, the first axis is parallel with the second axis and, the firstaxis is offset from the second axis.

It is a fifth aspect of the present invention to provide a method offorming a bone plate comprising fabricating a bone plate to include acombination compression and locking hole, where the combinationcompression and locking hole includes a first portion having a circularcross-section and a second portion having an oblong cross-section, wherethe circular cross-section and the oblong cross-section lie alongdiffering planes perpendicular to a central axis extending through thecombination compression and locking hole.

In yet another more detailed embodiment of the fifth aspect, thefabricating step includes machining a bone plate from a solid block ofmaterial. In still another more detailed embodiment, a first portion ofthe hole tapers to reduce a cross-sectional area of the hole. In afurther detailed embodiment, the fabricating step includes formingthreads within an interior surface of the bone plate demarcating thehole. In still a further detailed embodiment, the fabricating stepincludes removing some of the bone plate to increase at least one of awidth and a length of the hole after the hole has been formed.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is an elevated perspective view of an exemplary bone plateincorporating at least one combination locking and compression screwhole.

FIG. 2 is an overhead view of the exemplary combination locking andcompression screw hole shown in FIG. 1.

FIG. 3 is a cross-sectional view taken along line C in FIG. 2.

FIG. 4 is a cross-sectional view taken along line B in FIG. 2.

FIG. 5 is an overhead view of a locking screw hole while a portion isbored out using an end mill.

FIG. 6 is an overhead view of the locking screw hole of FIG. 5, with anopposing portion being bored out using an end mill to form thecombination locking and compression screw hole.

FIG. 7 is an elevated perspective view of an exemplary locking screw.

FIG. 8 is a vertical cross-section of the exemplary locking screw ofFIG. 7 taken at the middle.

FIG. 9 is an elevated perspective view of an exemplary compressionscrew.

FIG. 10 is a vertical cross-section of the exemplary compression screwof FIG. 9 taken at the middle.

FIG. 11 is a vertical cross-section of the exemplary bone plate of FIG.1 in position with respect to a bone, where a compression screw ispartially inserted into the combination locking and compression screwhole.

FIG. 12 is a vertical cross-section of the exemplary bone plate of FIG.1 in position with respect to a bone, where a compression screw is fullyinserted into the combination locking and compression screw hole inorder to shift the position of the plate and compress the bone.

FIG. 13 is a vertical cross-section of the exemplary bone plate of FIG.1 in position with respect to a bone, where a locking screw is partiallyinserted into the combination locking and compression screw hole.

FIG. 14 is a vertical cross-section of the exemplary bone plate of FIG.1 in position with respect to a bone, where a locking screw is fullyinserted into the combination locking and compression screw hole inorder to lock the angular position of the screw with respect to theplate and bone.

DETAILED DESCRIPTION

The exemplary embodiments of the present disclosure are described andillustrated below to encompass bone plates and, more specifically, tobone plates having fastener holes that may be utilized as locking holesor as compression holes, depending upon the initial placement of thefastener with respect to the fastener hole. Of course, it will beapparent to those of ordinary skill in the art that the preferredembodiments discussed below are exemplary in nature and may bereconfigured without departing from the scope and spirit of the presentinvention. However, for clarity and precision, the exemplary embodimentsas discussed below may include optional steps, methods, and featuresthat one of ordinary skill should recognize as not being a requisite tofall within the scope of the present invention.

Referencing FIG. 1, an exemplary bone plate 100 comprises a claviclebone plate. This clavicle bone plate 100 includes an elongated,longitudinal dimension that includes a series of fastener holes 102,103, 102A distributed in a spaced-apart fashion along the longitudinallength. Each fastener hole 102, 103, 102A extends between the topsurface 104 and bottom surface 106. In this exemplary embodiment, thetop surface 104 is generally convex from superior to inferior, while thebottom surface 106 is generally concave from superior to inferior. Thisshape is operative to form a channel defined by the bottom surface 106that is adapted to receive a biologic substrate, such as bone. And eachfastener hole 102, 103, 102A is generally centered between a superiorside 108 and an inferior side 110.

In this exemplary embodiment, the fastener holes 102, 103, 102Agenerally take on three forms. A first form hole 102 includes agenerally circular through opening that extends between the top andbottom surfaces 104, 106. This first form hole 102 has a horizontalcircular cross-section that changes in diameter in order to provide ataper in the hole, with the taper being located proximate the bottomsurface. It should be noted, however, that wherever a horizontalcross-section of this first hole 102 is taken, the cross-section will becircular. In order to form this hole, a milling machine (not shown) usesan end mill to remove material from the bone plate in order to form theinterior wall that defines the through hole. As part of this first formhole 102, the milling machine removes material from the hole to create ataper from top to bottom so that the area of the horizontal, circularcross-sections at some point between the top and bottom decreases. Afterthe milling machine has formed the hole, the wall of the hole isrelatively smooth. Thereafter, a threading procedure is carried out toform threads on the interior of the hole 102. These threads, however, donot generally change the circular cross-section of the hole. But thesecond form hole 103 does not include a horizontal circularcross-section.

In contrast to the first hole 102, the second form hole 103 includes anelongated shape having a non-circular cross-section. By way of example,the second form hole 103 includes a longitudinal dimension that isgreater than a widthwise dimension (superior to inferior). At the top ofthe second form hole 103, proximate the top surface 104, thelongitudinal dimension accommodates multiple longitudinal positions fora screw (such as a locking screw 180 or a compression screw 210). Butthe widthwise dimension is generally uniform and allows for positioningof the screw in only a single widthwise position. In other words, thesecond form hole 103 allows for positioning the screw in a number oflongitudinal positions, but the position of the screw in thesuperior-to-inferior (i.e., widthwise) direction is generally notamendable to multiple positions. Similarly, the first form hole 102 doesnot allow for multiple positions of the screw in theinferior-to-superior direction. But, conversely to the second form hole103, the first form hole 102 fails to allow multiple positions of thescrew in the longitudinal direction.

The two screw form holes 102, 103 also differ in that the first formhole 102 is threaded, while the second form hole 103 is not threaded. Inorder to retain the screw within the second form hole 103, acircumferential flange 140 (recessed in between the top and bottomsurfaces 104, 106) extends into the hole and is operative to decreasethe through hole diameter enough so that throughput of the screw head isretarded. Because of the longitudinal position variance provided by thesecond form hole 103, compression screws 210 are more commonly insertedinto this hole, as opposed to locking screws 180. As would be expected,the threaded nature of the first form hole 102 results in locking screws180 being inserted into these holes more commonly than compressionscrews 210.

A third form hole 102A comprises a hybrid hole that may be utilized as alocking screw hole or as a compression screw hole. In exemplary form,the hybrid fastener hole 102A includes a circular cross-section at thetop surface 104 and an oblong cross-section at the bottom surface 106.More specifically, the oblong cross-section of the hole 102A at thebottom surface 106 includes a first, larger dimension 112 runninglongitudinally along the longitudinal dimension of the hole 102A, and asecond, smaller dimension 114 running inferiorly between the superiorand inferior sides 108, 110. It should be noted that the largerdimension 112 is approximately the same as the diameter of the hole 102Aat the top surface 104. In this exemplary embodiment, the largerdimension 112 is 0.205 inches, while the smaller dimension is 0.145inches. Those skilled in the art will understand that differingdimensions (greater or lesser) are well within the scope of theinvention.

Located between the top and bottom surfaces 104, 106 for the first andthird form holes 102, 102A are helical threads 120 that extend fromportions of an interior wall 122 to delineate the vertical cross-sectionof each hole 102A. The interior wall 122 takes on a general shape thatresembles a bowl or a frustum, where portions of the interior wall 122departing from the bowl or frustum shape may not include the helicalthreads 120.

An exterior of the bone plate 100 includes a number of indentations 130that are formed into the superior and inferior sides 108, 110. Eachindentation 130 is located opposite another indentation so that a pairof indentations generally interposes consecutive fastener holes 102,102A. In this exemplary embodiment, each indentation 130 operates todecrease the widthwise dimension (superior 108 to inferior 110) of thebone plate 100, while at the same time cooperating with arcuatedepressions 132 to decrease the thickness (top surface 104 to bottomsurface 106) of the bone plate. Specifically, the arcuate depressions132 extend along the top surface 104 and terminate just shy of thesuperior-inferior midline extending longitudinally along the length ofthe bone plate 100.

To fabricate the exemplary bone plate 100, a solid block of metal (e.g.,stainless steel, titanium, etc.) is milled to form the general shape ofthe bone plate. This includes milling the bone plate 100 to have therequisite length, width, and thickness, in addition to providing a topsurface 104 that is convex and a bottom surface 106 that is concavealong the longitudinal length. In addition, the milling is operative toform the indentations 130 and remove material from the bone plate 100 inorder to form the depressions 132. After the general shape of the boneplate is finished, the fastener holes of the first and second form 102,103 are formed through the bone plate 100.

Referring to FIGS. 5 and 6, in order to form the hybrid holes 102A, anadditional step is taken to modify one or more of the first form holes102. Specifically, a milling machine is utilized to carry out a plungedown operation on the first form hole 102 that removes a portion of theinternal threads and interior wall in the longitudinal direction tocreate an oblong opening at the bottom of the hole. As discussedpreviously, the first form hole 102 has a diameter of 0.205 inches (anda circumferential curvature that matches this 0.205 inch diameter) atthe top surface 104 and a diameter of 0.145 inches at the bottom surface106 prior to the plunge down operation. After the plunge down operationis complete, the diameter of 0.205 inches at the top surface 104 remainsunchanged, while the longitudinal dimension of the hole at the bottomsurface 106 is changed to create an oblong shape. Specifically, theplunge down operation creates an oblong hole at the bottom surface 106having a longitudinal dimension of 0.205 inches, while maintaining thewidthwise dimension of 0.145 inches.

The plunge down operation involves using an end mill 150 having anoutside diameter of 0.138 inches, where the end mill is oriented inparallel to the through axial center of the hole and is longitudinallyoffset 0.03 inches from this axial center, but is centered in thesuperior-to-inferior direction. In a first plunge down operation (seeFIG. 5), the end mill 150 is longitudinally offset 0.03 inches in theproximal direction and removes a portion of the interior surface tocreate a wall having a circumferential curvature of a circle having adiameter of 0.138 inches. In a second plunge down operation, the endmill 150 is longitudinally offset 0.03 inches in the distal direction(see FIG. 6) and removes another portion of the interior surface tocreate another wall having a circumferential curvature of a circlehaving a diameter of 0.138 inches. The result of the plunge downoperation is a hole 102A having hybrid characteristics to accept eithera locking or compression screw 180, 210 without sacrificing thefunctionality of a locking screw or the functionality of a compressionscrew.

Referring to FIGS. 7 and 8, an exemplary locking screw 180 includes ahead 182 and a shaft 184 extending from the head. The head 182 comprisesa dome 186 that transitions into an arcuate circumferential surface 188that includes helical threads 190 adapted to engage the threads 120 ofthe bone plate holes 102, 102A. The circumferential surface 188transitions into an underneath planar surface 192 at the bottom of thehead 182 to take on a frustum profile. Opposite the bottom of the head182 is an opening 194 formed at the apex of the dome 186. The opening194 extends through the head 182 and into a head end 196 of the shaft184. In exemplary form, the opening 194 is defined by a series of sixalternating semicircular walls 198 and six straight walls 200 that forma hexagonal pattern. At the base of the walls 198, 200 is a conical wall202 that defines a conical part of the opening 194 terminating in thehead end 196 of the shaft 184. An exterior surface 204 of the shaft 184includes helical threads 206 that are adapted to engage a biologicsubstrate (not shown), such as bone. The threads 206 extend along theshaft until reaching a pointed projection 208 at a far end of the screw180.

Referencing FIGS. 9 and 10, an exemplary compression screw 210 includesa head 212 and a shaft 214 extending from the head. The head 212includes a dome 215 that transitions into a rounded or taperedcircumferential surface 216 that operates to decrease the cross-sectionof the head from proximal to distal, where the distal aspect transitionsinto the shaft. Extending through the dome 215 is an opening 218 thatextends through the head 212 and into a head end 220 of the shaft 214.In exemplary form, the opening 218 is defined by a series of sixalternating semicircular walls 220 and six straight walls 222 that forma hexagonal pattern. At the base of the walls 220, 222 is a conical wall224 that defines a conical part of the opening 218 terminating in thehead end 220 of the shaft 214. An exterior surface 226 of the shaft 214includes helical threads 228 that are adapted to engage a biologicsubstrate (not shown), such as bone. The threads 228 extend along theshaft 214 until reaching a tapered projection 230 at a far end of thescrew 210.

Referring to FIGS. 11 and 12, the hybrid holes 102A of the exemplarybone plate 100 may be utilized to receive a compression screw 210 inorder to exert a compressive force on the bone 240. In exemplary form, abone or bone fragments 240 is mounted to the bone plate 100 using acombination of compression and locking screws 210, 180. Presuming asurgeon finds it desirable to provide compression using the hybrid hole102A, a pilot hole may be drilled to receive a compression screw 210. Byway of example, the pilot hole is offset distally with respect the axialcenter of the hole 102A, which allows for the compression screw 210 tobe axially offset from the center of the hole (see FIG. 11). When thecompression screw 210 is initially inserted, the smaller diameterthreaded shaft 214 is aligned with the pilot hole and extends throughthe hybrid hole 102A with the shaft contacting, but not activelyengaging the threads on the side of the hole 102A. A pair of referencelines 242, 244 denotes the position of the bone 240 with respect to thebone plate 100 prior to compression. As the screw 210 is insertedfarther into the bone 240, the circumferential surface 216 of the head212 initially comes in contact with the top of the hole 102A.

When the circumferential surface 216 of the head 212 comes in contactwith the top of the hole 102A, further insertion of the head isoperative to push the head against the distal wall of the hole. Thiscauses the position of the bone plate 100 to shift distally with respectto the bone 240, thereby creating a compressive force on the bone in thedistal direction. As can be seen in FIG. 12, the reference lines 242,244 are no longer aligned, as the reference mark 242 for the plate 100has shifted distally with respect to the reference mark for the bone240.

Referring to FIGS. 13 and 14, the hybrid holes 102A of the exemplarybone plate 100 may be utilized to receive a locking screw 180, such as avariable angle locking screw, in order fix the position of the boneplate 100 with respect to the bone 240 where screw angles other thanperpendicular may be desired. In exemplary form, a bone or bonefragments 240 is mounted to the bone plate 100 using a combination ofcompression and locking screws 210, 180. Presuming a surgeon finds itdesirable to mount the plate 100 to the bone 240 using a locking screwat an angle other than perpendicular (perpendicular could also be usedas well), a pilot hole may be initially drilled. By way of example, thepilot hole is angled based upon the orientation of the bone or bonefragments 240. After the hole is drilled, a locking screw 180 isinserted through the hole 102A so that the smaller diameter threadedshaft 184 is aligned with the pilot hole. Thereafter, the locking screw180 is rotated to fasten the screw to the bone 240, while at the sametime pulling the head 182 into contact with the bounds of the hole 102A.Specifically, the threads 190 of the screw head 182 engage the threads120 on the interior of the hole 102A in order to lock the angularposition of the screw head (and screw) with respect to the bone plate100.

It should be noted that the dimensions set forth for the exemplaryembodiments are just that, exemplary. Deviations from these dimensionsmay be made without departing from the scope and spirit of the instantdisclosure. For example, the holes 102 may have an upper diameter largeror smaller than 0.205 inches. Likewise, the holes may not necessarilyhave a circular cross-section at any point. Moreover, the holes maygenerally take on any dimensions that provides for dual functionalityand use as both a compression hole and a locking hole.

Following from the above description and invention summaries, it shouldbe apparent to those of ordinary skill in the art that, while themethods and apparatuses herein described constitute exemplaryembodiments of the present invention, the invention contained herein isnot limited to this precise embodiment and that changes may be made tosuch embodiments without departing from the scope of the invention asdefined by the claims. Additionally, it is to be understood that theinvention is defined by the claims and it is not intended that anylimitations or elements describing the exemplary embodiments set forthherein are to be incorporated into the interpretation of any claimelement unless such limitation or element is explicitly stated.Likewise, it is to be understood that it is not necessary to meet any orall of the identified advantages or objects of the invention disclosedherein in order to fall within the scope of any claims, since theinvention is defined by the claims and since inherent and/or unforeseenadvantages of the present invention may exist even though they may nothave been explicitly discussed herein.

The invention claimed is:
 1. A bone plate including a length and havinga first side and a second side, the bone plate comprising: a top surfaceextending between the first side and the second side; a bottom surfaceextending between the first side and the second side; a plurality ofholes including three different forms of holes, wherein each of thethree different forms of holes extends from the top surface to thebottom surface, the plurality of holes being distributed in spaced-apartfashion along the length, the three different forms of holes including(i) a hybrid screw hole configured to accept both a locking screw and acompression screw, (ii) a threaded first form hole configured to accepta locking screw, wherein the first form hole is configured to taper fromthe top surface to the bottom surface so that an area of a threadedhorizontal, circular cross-section decreases at some point between thetop surface and the bottom surface and (iii) a second form hole havingan elongated shape with a non-circular cross-section and acircumferential flange recessed in between the top surface and thebottom surface, the second form hole configured to accept a compressionscrew, wherein each of the three different forms of holes does not sharea common center with another of the three different forms of holes;wherein the elongated shape of the second form hole includes alongitudinal dimension arranged along a length of the bone plate and awidthwise dimension less than the longitudinal dimension, wherein thelongitudinal dimension includes a length sufficient to locate acompression screw in a number of longitudinal positions but thewidthwise dimension is insufficient to locate a compression screw in anumber of positions substantially normal to the longitudinal position;wherein the hybrid screw hole includes a top opening at the top surfaceand a bottom opening at the bottom surface, the top opening defining afirst cross-section having a circular shape at the top surface of thebone plate and including a widthwise dimension and a lengthwisedimension normal to the widthwise dimension, and the bottom openingdefining a second cross-section having an oblong shape at the bottomsurface of the bone plate; and wherein an interior wall of the boneplate extends between the top opening and the bottom opening of thehybrid screw hole, the interior wall having a threaded first portionproximate the top opening and an unthreaded second portion extendingfrom the bottom opening.
 2. The bone plate of claim 1 wherein thethreaded first portion of the interior wall of the hybrid screw hole ishelically threaded and configured to taper inwardly between the topsurface of the bone plate and the unthreaded second portion of theinterior wall, and where at least one of the widthwise dimension and thelengthwise dimension is decreased between the top opening and the bottomopening, while the other of the widthwise dimension and the lengthwisedimension does not substantially decrease between the top opening andthe bottom opening.
 3. The bone plate of claim 2 wherein the unthreadedsecond portion of the interior wall includes a smooth vertical surface.4. The bone plate of claim 3 further comprising a plurality ofindentations disposed along the first side and the second side, whereineach of the plurality of indentations is configured to decrease awidthwise dimension of the bone plate between the first side and thesecond side; and a plurality of arcuate depressions each beingconfigured to extend from the top surface and to extend toward asuperior-inferior midline of the bone plate.
 5. The bone plate of claim4 wherein each of the plurality of indentations is located oppositeanother of the plurality of indentation such that a pair of indentationsis generally located between consecutive ones of the plurality of holesalong at least one of the first side and second side.
 6. The bone plateof claim 5 wherein each of the plurality of arcuate depressions islocated adjacent to one of the plurality of indentations and whereineach of the plurality of indentations includes a first edge havingterminating ends terminating at the bottom surface and at the one of thefirst side and second side, and each of the plurality of arcuatedepressions includes a second edge having terminating ends terminatingat the first edge.
 7. A bone plate including a length and having a firstside and a second side, the bone plate comprising: a top surfaceextending between the first side and the second side; a bottom surfaceextending between the first side and the second side; and a plurality ofholes including three different forms of holes, wherein each of thethree different forms of holes extends from the top surface to thebottom surface, the plurality of holes being distributed in spaced-apartfashion along the length, the three different forms of holes including(i) a hybrid screw hole configured to accept both a locking screw and acompression screw, (ii) a threaded first form hole configured to accepta locking screw, wherein the first form hole is configured to taper fromthe top surface to the bottom surface so that an area of a threadedhorizontal, circular cross-section decreases at some point between thetop surface and the bottom surface and (iii) a second form hole havingan elongated shape with a non-circular cross-section and acircumferential flange recessed in between the top surface and thebottom surface, the second form hole configured to accept a compressionscrew, wherein each of the three different forms of holes does not sharea common center with another of the three different forms of holes;wherein the hybrid screw hole includes a top opening at the top surfaceand a bottom opening at the bottom surface, wherein an interior wall ofthe bone plate extends between the top opening and the bottom opening ofthe hybrid screw hole, the interior wall having a helically threadedfirst portion proximate the top opening and an unthreaded second portionextending from the bottom opening.
 8. The bone plate of claim 7 whereinthe top opening defines a first cross-section having a circular shape atthe top surface of the bone plate and including a widthwise dimensionand a lengthwise dimension normal to the widthwise dimension, and thebottom opening defining a second cross-section having an oblong shape atthe bottom surface of the bone plate.
 9. The bone plate of claim 8wherein the helically threaded first portion of the interior wall isconfigured to taper inwardly between the top surface of the bone plateand the unthreaded second portion of the interior wall, and where atleast one of the widthwise dimension and the lengthwise dimension isdecreased between the top opening and the bottom opening, while theother of the widthwise dimension and the lengthwise dimension does notsubstantially decrease between the top opening and the bottom opening.10. A bone plate including a length and having a first side and a secondside, the bone plate comprising: a top surface extending between thefirst side and the second side; a bottom surface extending between thefirst side and the second side; a plurality of holes including threedifferent forms of holes, wherein each of the three different forms ofholes extends from the top surface to the bottom surface, the pluralityof holes being distributed in spaced-apart fashion along the length, thethree different forms of holes including (i) a hybrid screw holeconfigured to accept both a locking screw and a compression screw, (ii)a threaded first form hole configured to accept a locking screw, whereinthe first form hole is configured to taper from the top surface to thebottom surface so that an area of a threaded horizontal, circularcross-section decreases at some point between the top surface and thebottom surface and (iii) a second form hole having an elongated shapewith a non-circular cross-section and a circumferential flange recessedin between the top surface and the bottom surface, the second form holeconfigured to accept a compression screw, wherein each of the threedifferent forms of holes does not share a common center with another ofthe three different forms of holes; wherein the hybrid screw holeincludes a top opening at the top surface and a bottom opening at thebottom surface, wherein an interior wall of the bone plate extendsbetween the top opening and the bottom opening of the hybrid screw hole,the interior wall having a helically threaded first portion proximatethe top opening and an unthreaded second portion extending from thebottom opening; wherein the top opening defines a first cross-sectionhaving a circular shape at the top surface of the bone plate andincluding a widthwise dimension and a lengthwise dimension normal to thewidthwise dimension, and the bottom opening defining a secondcross-section having an oblong shape at the bottom surface of the boneplate; wherein the helically threaded first portion of the interior wallis configured to taper inwardly between the top surface of the boneplate and the unthreaded second portion of the interior wall, and whereat least one of the widthwise dimension and the lengthwise dimension isdecreased between the top opening and the bottom opening, while theother of the widthwise dimension and the lengthwise dimension does notsubstantially decrease between the top opening and the bottom opening;and wherein the second form hole is unthreaded and the elongated shapeof the second form hole includes a longitudinal dimension arranged alonga length of the bone plate and a widthwise dimension less than thelongitudinal dimension, wherein the longitudinal dimension includes alength sufficient to locate a compression screw in a number oflongitudinal positions but the widthwise dimension is insufficient tolocate a compression screw in a number of positions substantially normalto the longitudinal position.
 11. The bone plate of claim 10 furthercomprising a plurality of indentations disposed along the first side andthe second side, wherein each of the plurality of indentations isconfigured to decrease a widthwise dimension of the bone plate betweenthe first side and the second side; and a plurality of arcuatedepressions each being configured to extend from the top surface and toextend toward a superior-inferior midline of the bone plate.
 12. Thebone plate of claim 11 wherein the unthreaded second portion of theinterior wall includes a smooth vertical surface.
 13. The bone plate ofclaim 12 wherein each of the plurality of indentations is locatedopposite another of the plurality of indentation such that a pair ofindentations is generally located between consecutive ones of theplurality of holes along at least one of the first side and second side.14. The bone plate of claim 13 wherein each of the plurality of arcuatedepressions is located adjacent to one of the plurality of indentations.15. The bone plate of claim 14 wherein each of the plurality ofindentations includes a first edge having terminating ends terminatingat the bottom surface and at the one of the first side and second side,and each of the plurality of arcuate depressions includes a second edgehaving terminating ends terminating at the first edge.
 16. A bone plateincluding a length and having a first side and a second side, the boneplate comprising: a top surface extending between the first side and thesecond side; a bottom surface extending between the first side and thesecond side; and a plurality of holes including three different forms ofholes, wherein each of the three different forms of holes extends fromthe top surface to the bottom surface, the plurality of holes beingdistributed in spaced-apart fashion along the length, the threedifferent forms of holes including (i) a partially threaded hybrid screwhole configured to accept both a locking screw and a compression screw,the partially threaded hybrid screw hole including an interior wall ofthe bone plate configured to extend between a top opening at the topsurface to a bottom opening at the bottom surface of the hybrid screwhole, the interior wall including a helically threaded first portionwith a first cross-section having a circular shape at the top surfaceand an unthreaded second portion extending from the bottom openingdefining a second cross-section having an oblong shape at the bottomsurface, (ii) a threaded first form hole configured to accept a lockingscrew, wherein the first form hole is configured to taper from the topsurface to the bottom surface so that an area of a threaded horizontal,circular cross-section decreases at some point between the top surfaceand the bottom surface and (iii) a second form hole having an elongatedshape with a non-circular cross-section, the second form hole configuredto accept a compression screw, wherein each of the three different formsof holes does not share a common center with another of the threedifferent forms of holes.
 17. The bone plate of claim 16 wherein thesecond form hole includes a circumferential flange recessed in betweenthe top surface and the bottom surface.
 18. The bone plate of claim 17wherein the second form hole is unthreaded and the elongated shape ofthe second form hole includes a longitudinal dimension arranged along alength of the bone plate and a widthwise dimension less than thelongitudinal dimension, wherein the longitudinal dimension includes alength sufficient to locate a compression screw in a number oflongitudinal positions but the widthwise dimension is insufficient tolocate a compression screw in a number of positions substantially normalto the longitudinal position.